Cooling Therapy

The normal core body temperature is 98.6 degrees Fahrenheit. Therapeutic hypothermia treatment cools the infant’s body to a temperature of 92 degrees Fahrenheit. This temperature is widely considered the optimal temperature for treatment of HIE. Neonatal cooling is done using either a blanket or cap. A cooling cap is fitted to the baby’s head and provides consistent temperature lowering. It also typically includes built-in EEG to monitor the baby’s brain activity.

A cooling blanket is also called a mat. It uses water to maintain a constant temperature. The baby is placed on the blanket for the duration of treatment. Both methods provide proper neonatal therapeutic hypothermia. Therapy must be started within 6 hours of birth in order to be useful. Therapy continues for up to 72 hours to be effective.

During therapy, the body’s temperature is lowered. This lowered body temperature allows the body’s metabolism to slow and this, in turn, provides more time to provide important medications and other therapies to the baby to try to reduce or limit the severity of brain damage. The first hours after birth are crucial because that is when the body suffers secondary effects of lack of oxygen. The baby may require medications such as those to reduce the incidence of seizures and to stabilize blood pressure.

Benefits

Infants who suffer a lack of oxygen during or after birth may suffer varying degrees of neurological damage. Neonatal cooling may provide some reduction in the potential severity of damage. Those who receive treatment may have lower mortality rates and could have improved brain function over those who did not get the treatment.

There are generally considered to be more benefits than the potential harm done by therapeutic hypothermia. When administered properly the therapy is safe. The most common side effect is a slowed heart rate, also known as sinus bradycardia. This is a non-life-threatening condition that is closely monitored and treated while the infant is being cared for in the NICU.

Where is Cooling Therapy Provided?

Treatment must be provided at a hospital with a Neonatal Intensive Care Unit, NICU. These facilities are properly equipped to handle testing and diagnosis of HIE and to provide treatment for any potential complications. Although not all hospitals currently have the ability to provide this type of treatment many are obtaining them. If an infant requires neonatal cooling and it is not provided at the current hospital arrangements may be made to transport the infant to a NICU that offers the treatment as long as they are close enough to treat the newborn within 6 hours of birth.

hat Happens After Cooling Therapy?

Infants are monitored and evaluated throughout the therapeutic hypothermia process. After the process is complete, the infant is slowly warmed to normal temperature. While undergoing treatment, the baby was likely under sedation, which may now be reduced. The baby was receiving nutrition intravenously. Once warmed, the infant can be fully evaluated to determine his current condition.